Prehospital identification of trauma patients requiring transfusion: results of a retrospective study evaluating the use of the trauma induced coagulopathy clinical score (TICCS) in 33,385 patients from the TraumaRegister DGU®

Background: Identifying trauma patients that need emergent blood product transfusion is
crucial. The Trauma Induced Coagulopathy Clinical Score (TICCS) is an easy-to-measure score
developed to meet this medical need. We hypothesized that TICCS would assist in identifying
patients that need a transfusion in a large cohort of severe trauma patients from the
TraumaRegister DGUVR (TR-DGU).
Materials and methods: A total of 33,385 severe trauma patients were extracted from the
TR-DGU for retrospective analysis. The TICCS was adapted for the registry structure. Blood
transfusion was defined as the use of at least one unit of red blood cells (RBC) during acute
hospital treatment.
Results: With an area under the receiving operating curve (AUC) of 0.700 (95% CI:
0.691–0.709), the TICCS appeared to be moderately discriminant for determining the need
for RBC transfusion in the trauma population of the TR-DGU. A TICCS cut-off value of 12
yielded the best trade-off between true positives and false positives. The corresponding positive
predictive value and negative predictive values were 48.4% and 89.1%, respectively.
Conclusion: This retrospective study confirms that the TICCS is a useful and simple score for
discriminating between trauma patients with and without the need for emergent blood
product transfusion.